Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Sep 13;6(17):4975-4982.
doi: 10.1182/bloodadvances.2022007940.

American Society of Hematology living guidelines on the use of anticoagulation for thromboprophylaxis for patients with COVID-19: March 2022 update on the use of anticoagulation in critically ill patients

Adam Cuker  1 , Eric K Tseng  2 , Holger J Schünemann  3   4 , Pantep Angchaisuksiri  5 , Clifton Blair  6 , Kathryn Dane  7 , Maria T DeSancho  8 , David Diuguid  9 , Daniel O Griffin  10   11   12 , Susan R Kahn  13 , Frederikus A Klok  14 , Alfred Ian Lee  15 , Ignacio Neumann  16 , Ashok Pai  17 , Marc Righini  18 , Kristen M Sanfilippo  19 , Deborah M Siegal  20 , Mike Skara  21 , Deirdra R Terrell  22 , Kamshad Touri  23 , Elie A Akl  24 , Reyad Al Jabiri  25 , Yazan Al Jabiri  26 , Mary Boulos  3 , Romina Brignardello-Petersen  3 , Rana Charide  27 , Luis E Colunga-Lozano  28 , Karin Dearness  29 , Andrea J Darzi  3 , Samer G Karam  3 , Gian Paolo Morgano  3 , Rami Z Morsi  30 , Binu A Philip  3 , Yetiani Roldan Benitez  3 , Adrienne Stevens  3 , Karla Solo  3 , Wojtek Wiercioch  3 , Reem A Mustafa  3   31 , Robby Nieuwlaat  3
Affiliations

American Society of Hematology living guidelines on the use of anticoagulation for thromboprophylaxis for patients with COVID-19: March 2022 update on the use of anticoagulation in critically ill patients

Adam Cuker et al. Blood Adv. .

Update in

  • doi: 10.1182/bloodadvances.2020003763

Abstract

Background: COVID-19-related critical illness is associated with an increased risk of venous thromboembolism (VTE).

Objective: These evidence-based guidelines of the American Society of Hematology (ASH) are intended to support patients, clinicians, and other health care professionals in decisions about the use of anticoagulation for patients with COVID-19.

Methods: ASH formed a multidisciplinary guideline panel, including 3 patient representatives, and applied strategies to minimize potential bias from conflicts of interest. The McMaster University Grading of Recommendations Assessment, Development and Evaluation (GRADE) Centre supported the guideline development process, including performing systematic evidence reviews (up to January 2022). The panel prioritized clinical questions and outcomes according to their importance for clinicians and patients. The panel used the GRADE approach to assess evidence and make recommendations, which were subject to public comment. This is an update to guidelines published in February 2021 and May 2021 as part of the living phase of these guidelines.

Results: The panel made 1 additional recommendation: a conditional recommendation for the use of prophylactic-intensity over therapeutic-intensity anticoagulation for patients with COVID-19-related critical illness who do not have suspected or confirmed VTE. The panel emphasized the need for an individualized assessment of thrombotic and bleeding risk.

Conclusions: This conditional recommendation was based on very low certainty in the evidence, underscoring the need for additional, high-quality, randomized controlled trials comparing different intensities of anticoagulation for patients with COVID-19-related critical illness.

PubMed Disclaimer

Figures

None
Graphical abstract
See this image and copyright information in PMC

References

    1. Nopp S, Moik F, Jilma B, Pabinger I, Ay C. Risk of venous thromboembolism for patients with COVID-19: a systematic review and meta-analysis. Res Pract Thromb Haemost. 2020;4(7):1178-1191. - PMC - PubMed
    1. Jiménez D, García-Sanchez A, Rali P, et al. . Incidence of VTE and bleeding among hospitalized patients with coronavirus disease 2019: a systematic review and meta-analysis. Chest. 2021;159(3):1182-1196. - PMC - PubMed
    1. Cuker A, Tseng EK, Nieuwlaat R, et al. . American Society of Hematology 2021 guidelines on the use of anticoagulation for thromboprophylaxis for patients with COVID-19. Blood Adv. 2021;5(3):872-888. - PMC - PubMed
    1. Institute of Medicine Committee on Standards for Developing Trustworthy Clinical Practice Guidelines. Clinical Practice Guidelines We Can Trust. Washington, DC: National Academic Press; 2011.
    1. Schünemann HJ, Al-Ansary LA, Forland F, et al. ; Board of Trustees of the Guidelines International Network . Guidelines International Network: principles for disclosure of interests and management of conflicts in guidelines. Ann Intern Med. 2015;163(7):548-553. - PubMed

Publication types